MEDICARE: KRISTINE ROSE BARRETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	NO LICENSURE IN CO	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1060725	OTHER	CO	OTR CERTIFICATION NUMBER

General Provider Information

NPI Number	:	1386843068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE ROSE BARRETT

Provider Business Mailing Address
First Line	:	3104 SWALLOW PL
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 W TRILBY RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-4054
Country	:	US
Telephone Number	:	970-226-6408
Fax Number	:	970-226-1015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

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Directions to “ KRISTINE ROSE BARRETT ” Practice Location

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